Music & Memory Assessment Survey

Listener’s Name

Question Title

* 1. Listener’s Name

Age

Question Title

* 2. Age

Native Language

Question Title

* 3. Native Language

English

Cantonese

Korean

Japanese

Mandarin

Vietnamese

Other (please specify)

Where did you grow up?

Question Title

* 4. Where did you grow up?

What is your favorite type of music?

Question Title

* 5. What is your favorite type of music?

What music did you listen to when you were young?

Question Title

* 6. What music did you listen to when you were young?

Who was your favorite performer, group, band, or orchestra?

Question Title

* 7. Who was your favorite performer, group, band, or orchestra?

Did you sing at religious services?

Question Title

* 8. Did you sing at religious services?

Yes

What faith/denomination and in which part of the country?

Question Title

* 9. What faith/denomination and in which part of the country?

What are your favorite hymns or other religious music (if any)?

Question Title

* 10. What are your favorite hymns or other religious music (if any)?

Did you enjoy going to Broadway shows or musicals?

Question Title

* 11. Did you enjoy going to Broadway shows or musicals?

Yes

What were your favorite TV shows or movies?

Question Title

* 12. What were your favorite TV shows or movies?

What kind of live music did you enjoy?

Question Title

* 13. What kind of live music did you enjoy?

Jazz Clubs

Symphony Performances

Ballet Performances

Rock Concerts

DJ Music in Clubs

Other (please specify)

Do you like to dance? What type of dance?

Question Title

* 14. Do you like to dance? What type of dance?

Do you have a favorite classical music composer?

Question Title

* 15. Do you have a favorite classical music composer?

What songs did you dance to at your wedding? High school prom?

Question Title

* 16. What songs did you dance to at your wedding? High school prom?

Were you in the armed services? What branch, when and where did you serve?

Question Title

* 17. Were you in the armed services? What branch, when and where did you serve?

Do you still have any records, tapes, or CDs that were favorites? Where can I find them?

Question Title

* 18. Do you still have any records, tapes, or CDs that were favorites? Where can I find them?

Can you hum any favorite songs?

Question Title

* 19. Can you hum any favorite songs?

Yes

Other Notes

Question Title

* 1. Listener’s Name

Question Title

* 2. Age

Question Title

* 3. Native Language

Question Title

* 4. Where did you grow up?

Question Title

* 5. What is your favorite type of music?

Question Title

* 6. What music did you listen to when you were young?

Question Title

* 7. Who was your favorite performer, group, band, or orchestra?

Question Title

* 8. Did you sing at religious services?

Question Title

* 9. What faith/denomination and in which part of the country?

Question Title

* 10. What are your favorite hymns or other religious music (if any)?

Question Title

* 11. Did you enjoy going to Broadway shows or musicals?

Question Title

* 12. What were your favorite TV shows or movies?

Question Title

* 13. What kind of live music did you enjoy?

Question Title

* 14. Do you like to dance? What type of dance?

Question Title

* 15. Do you have a favorite classical music composer?

Question Title

* 16. What songs did you dance to at your wedding? High school prom?

Question Title

* 17. Were you in the armed services? What branch, when and where did you serve?

Question Title

* 18. Do you still have any records, tapes, or CDs that were favorites? Where can I find them?

Question Title

* 19. Can you hum any favorite songs?

Question Title

* 20. Other Notes